Includes bibliographical references (pages 343-378) and indexes

I. THE RISE OF ADDICTION AND PERSONAL RECOVERY MOVEMENTS IN THE NINETEENTH CENTURY -- THE SEEDS OF ADDICTION MEDICINE AND PERSONAL RECOVERY MOVEMENTS -- Early American drinking -- Benjamin Rush and the birth of the American disease concept of alcoholism -- A new republic on a binge -- The rise and evolution of the American temperance movement -- Alcoholics and the evolution in temperance philosophy -- Early involvement of alcoholics in the temperance movement -- From individual struggle to shared recovery -- The tortured saga of Luther Benson -- THE WASHINGTONIAN REVIVAL -- Founding and growth of the Washingtonians -- The Washingtonian program -- John Hawkins and John Gough -- The Washingtonian demise -- The Washingtonian legacy -- FRATERNAL TEMPERANCE SOCIETIES AND REFORM CLUBS -- Osgood's Reformed Drinkers Club -- Reynold's Red Ribbon Reform Clubs -- Francis Murphy's Blue Ribbon Reform Clubs -- Reform clubs' operation and spread -- The Business Men's Moderation Society -- II. THE BIRTH OF ADDICTION TREATMENT IN AMERICA -- THE RISE AND FALL OF INEBRIATE HOMES AND ASYLUMS -- Pre-asylum days: knowledge of addiction -- Pre-asylum day[s]: care of the addicted -- The earliest institutions -- Types of institutions -- Sponsorship and financing -- Relationship with other community institutions -- Early professionalization: the American Association for the Cure of Inebriates -- The decline of the inebriate asylums -- A post-mortem of the inebriate asylum movement -- INEBRIATE HOMES AND ASYLUMS: TREATMENT METHODS, PHILOSOPHIES, AND OUTCOMES -- The staff -- The patients: a demographic profile -- The patients: a clinical profile -- Treatment philosophies -- Treatment methods -- The family and the inebriate asylum -- Aftercare -- Reported treatment outcomes -- The treatment of alcoholism and other addictions in women -- FOUR INSTITUTIONAL HISTORIES -- The New York State inebriate asylum -- The Boston Washingtonian home -- The Chicago Washingtonian home -- The San Francisco home for the care of the inebriate -- FRANCHISING ADDICTION TREATMENT: THE KEELEY INSTITUTES

Humble beginnings of a national phenomenon -- Keeley: on the causes of inebriety -- The Keeley patients -- The Keeley staff -- The Keeley treatment -- The mail-order business -- The Keeley leagues -- Reported treatment outcomes -- Other gold cures -- Early controversies and critics -- Turn-of-the-century decline -- The later Keeley years: 1900-1966 -- The Keeley legacy -- MIRACLE CURES OF ALCOHOLISM AND OTHER ADDICTIONS -- The context -- The products -- Promotional schemes -- Exposés and legislative reform -- Continued presence of fraudulent "cures" -- Fraud as a theme in the early history of treatment -- RELIGIOUS CONVERSION AS A REMEDY FOR ALCOHOLISM -- Religion and recovery: historical roots -- Skid Row, the Bowery, and the birth of the rescue mission -- Jerry McAuley's Water Street mission -- The Salvation Army -- America's Keswick Colony of Mercy -- Early professional views on religion and recovery -- Conversion and recovery: the ideas of William James -- Later professional perspectives -- Critics of religious approaches to alcoholism recovery -- ALCOHOLISM TREATMENT SETTINGS: 1900-1940 -- The inebriate farm/colony -- Alcoholism and city hospitals -- Alcoholics in local psychopathic hospitals and state psychiatric hospitals -- Drying out the rich and famous: a continuing story -- The saga of Willie Seabrook -- The Charles B. Towns hospital for the treatment of drug and alcholic addictions -- PHYSICAL METHODS OF TREATMENT AND CONTAINMENT -- Physical treatments for alcoholism between 1840 and 1950: an overview -- Eugenics: sterilization and benign neglect -- Natural therapeutics -- The water cures -- Drug therapies: 1860-1930 -- Convulsive therapies -- Psychosurgery and addiction: the lobotomy era -- Miscellaneous treatments -- PSYCHOLOGICAL APPROACHES TO ALCOHOLISM AND ADDICTION TREATMENT -- The psychoanalytic approach -- The Emmanuel Clinic and the lay therapy movement -- Aversion therapy: early efforts -- IV. TREATING ADDICTIONS TO NARCOTICS AND OTHER DRUGS -- 1880-1925 -- The use of cocaine as an addiction cure, and Freud's retraction -- Cocaine, morphine, and the father of American surgery -- Opiate addiction: a hidden disease -- Drug treatments and drug cures before the Harrison Act

Drug treatment, the Harrison Act, drug enforcement, and the Supreme Court -- The morphine maintenance clinics -- 1925-1950 -- Voices of protest -- 1920-1950: medical detoxification and hidden drug maintenance -- Dr. Thomas Ratigan, Jr.: villain or hero? -- Phantastica and narcotics research -- The federal narcotic forms -- The addiction research center -- The world outside Lexington and Ft. Worth -- V. AA AND THE MODERN ALCOHOLISM MOVEMENT -- THE BIRTH OF ALCOHOLICS ANONYMOUS: A BRIEF HISTORY -- Carl Jung and Rowland H.'s failed psychotherapy -- The Oxford group -- The Oxford groups, Ebby T. and Bill W.'s "hot flash" -- Bill W. meets Dr. Bob -- A.A. identity and early A.A. growth -- Grandiose visions -- The "big book" -- Early rituals -- The period of explosive growth -- A maturing A.A. -- Those who shaped the A.A. treatment relationship (Bill Wilson, Dr. Bob Smith, Dr. William D. Silkworth, Sister Ignatia, Dr. Harry M. Tiebout) -- THE PROGRAM OF ALCOHOLICS ANONYMOUS -- Defining the A.A. program -- A.A. steps and A.A. practices -- A.A. experience and A.A. logic -- Identity reconstruction within A.A. -- Reconstruction of personal relationships -- Reconstruction of daily lifestyle within A.A. -- Reframing: the curse that became a blessing -- The recovery program of A.A. and its predecessors: shared characteristics -- Innovations in A.A.'s program of recovery -- A.A.'s organizational structure and practices -- A.A's mission -- A.A.'s philosophy of addiction -- A.A.'s prescription for short- and long-term recovery -- Carrying the message of A.A. recovery -- Internal A.A. relationships -- Defining A.A. membership -- The expected duration of A.A. participation -- Power and decision-making in A.A. -- The voice of A.A. -- A.A. relationships with allied fields and related causes -- Managing member growth -- Leader development -- Managing the issues of money, property, and personal ambition -- Social context and organizational endurance -- A.A. CRITICS AND A.A. LEGACY -- Stretching A.A.'s gateway of entry: women and people of color in A.A. -- A.A.'s place in history -- A.A. AND THE PROFESSIONAL CARE OF ALCOHOLICS: 1935-1960 -- Visions of A.A. hospitals -- The Knickerbocker paradox: actions of A.A. versus actions of A.A. members

St. Thomas: the beginning of a model -- Model evolution: A.A. involvement with private and public hospitals -- Model extension: A.A. and private hospitals, sanitaria, and psychiatric institutions -- A.A. members as moral and business entrepreneurs -- The boundary between treatment and A.A.: the story of High Watch -- The distinction between A.A. and treatment -- A.A. and alcoholism treatment: a synopsis -- THE "MODERN ALCOHOLISM MOVEMENT": THE CORE -- The context -- The alcohol and alcoholism movements -- The volatility of the post-repeal period -- Research council on the problems of alcohol -- The Yale Center of alcohol studies -- The National Committee for Education on Alcoholism -- THE "MODERN ALCOHOLISM MOVEMENT": THE PERIPHERY -- Changing medical opinion on alcoholics and alcoholism -- The alcoholism movement in the workplace -- Alcoholism movement in the church -- Municipal, state, and federal responses to alcoholism -- R. Brinkley Smithers: private philanthropy and the alcoholism movement -- The role of A.A. and recovered alcoholics in the alcoholism movement -- The role of the alcohol beverage industry in the alcoholism movement -- The legacies of the alcoholism movement -- Origin of the modern disease concept -- VI. MID-CENTURY ADDICTION TREATMENT -- THE BIRTH AND SPREAD OF THE "MINNESOTA MODEL" -- Pre-A.A. history -- The story of Pat C. -- Pioneer House -- Hazelden: the early years -- Willmar State Hospital -- Hazelden: the continuing story -- Further Minnesota developments -- Defining the Minnesota model -- Why Minnesota? -- The spread of the Minnesota model -- Further contributions to the Minnesota model -- MID-CENTURY ALCOHOLISM TREATMENTS -- Organizational activity in the alcoholism field: 1950-1960 -- Expanding knowledge and ideas about alcoholism -- Mid-century alcoholism treatment: an overview -- A.A. and mutual aid: 1950-1971 -- Other mutual aid societies: Alcoholics Victorious and the Calix Society -- MID-CENTURY ALCOHOLISM TREATMENT: TREATMENT METHODS -- Hypnosis revisited -- Physical methods of alcoholism treatment: an overview -- Nutrition, alcoholism, and vitamin therapy -- ACTH: alcoholism and endocrine dysfunction -- The use of tranquilizers, anti-depressants, mood stabilizers, and sedatives

Benzedrine in the treatment of alcoholism -- Antabuse and other antidipsotropics in the treatment of alcoholism -- LSD and the treatment of alcoholism -- Miscellaneous and multi-drug therapies -- The carbon dioxide treatment for alcoholism -- Advances in psychosocial rehabilitation technology -- The halfway house movement -- MID-CENTURY ADDICTION TREATMENT: THE RISE OF NEW APPROACHES -- The legal context -- Medical and psychiatric context -- Juvenile addiction: the story of Riverside Hospital -- Community-based support of institutionalized addicts -- Religious approaches to addiction recovery -- Narcotics Anonymous -- Synanon: the birth of ex-addict directed therapeutic communities -- The therapeutic community movement -- The therapeutic community: treatment methods -- MID-CENTURY ADDICTION TREATMENT: PART TWO -- Civil commitments -- Methadone and modern narcotic maintenance -- The methadone critics -- Methadone, Watergate, and federal narcotics control -- Narcotics antagonists -- Multimodality treatment systems: the story of the Illinois Drug Abuse Program -- Lexington and Fort Worth: the twilight years -- VII. ADDICTION TREATMENT IN THE LATE TWENTIETH CENTURY -- THE MODERN EVOLUTION OF ADDICTION TREATMENT -- Reaching critical mass -- The Cooperative Commission on the Study of Alcoholism -- The deluge of addiction treatment legislation -- Local sponsorship and organization -- Two worlds: alcoholism and drug abuse -- Early programs: what it was like -- Alcoholism: an insurmountable illness -- Program accreditation and licensure -- Three worlds: public, private, and military -- The rebirth of addiction medicine -- An evolving workforce -- A hidden story: the exploitation and relapse of recovering alcoholics and addicts -- Professionalization: training, credentialing, and worker certification -- Explosive growth -- Early intervention programs -- Recovery as a cultural phenomenon -- Expansion and diversification of mutual-aid societies -- Competition, profit, and profiteering -- Ethical context and breaches of ethical conduct -- The financial backlash -- The ideological and cultural backlash -- The crash -- A panicked field in search of the soul and its future -- MODERN ADDICTION TREATMENT: SEMINAL IDEAS AND EVOLVING TREATMENT TECHNOLOGY

Eleven seminal/controversial ideas -- The concept of inebriety reborn -- From a single to a multiple pathway model of addiction and recovery -- The biology of addiction -- Toward a developmental model of alcoholism recovery -- Addiction as a chronic disease -- The continuum-of-care concept -- Rethinking motivation: pain versus hope -- Needle exchanges: a harm-reduction case study -- Natural recovery, spontaneous remission and maturing out -- The question of controlled drinking and drug use -- Codependency: popularization and backlash -- Treatment of special populations and treatment in special settings -- The public inebriate -- Changing responses to the drunk driver -- Gender-specific treatment -- Adolescent treatment -- The employed alcoholic/addict -- Treating impaired professionals -- Treatment in the military -- Cultural-specific and culturally competent treatment -- The addicted offender -- Treating addicts with HIV/AIDS -- The multiple-problem client -- Modern addiction treatment technologies -- Treatment evaluation research -- PARKSIDE: A RICH LEGACY AND A CAUTIONARY TALE -- The birth -- Early influences -- The early program -- Contrasts between Lutheran General and Hazelden -- The treatment term -- The role of the alcoholism counselor -- The A.A./treatment center relationship -- Al-Anon and family programming -- Early diversification -- Evaluation research -- Model dissemination -- Explosive growth -- Later diversification -- The demise -- Lessions and legacies -- A lasting legacy -- SOME CLOSING REFLECTIONS ON THE LESSONS OF HISTORY -- Approaching history -- Recovery -- Addiction science -- The rise of treatment institutions and mutual-aid societies -- Observations on the treatment field -- Treatment in relationship to community and society -- The fall of treatment institutions and mutual aid -- The future of treatment -- Final words

"This is the remarkable story of America's personal and instituional responses to alcoholism and other addictions. It is the story of mutual aid societies: the Washingtonians, the Blue Ribbon Reform Clubs, the Ollapod Club, the United Order of Ex-Boozers, the Jacoby Club, Alcoholics Anonymous and Women for Sobriety. It is a story of addiction treatment institutions from the inebriate asylums and Keeley Institutes to Hazelden and Parkside. It is the story of evolving treatment interventions that range from water cures and mandatory sterilization to aversion therapies and methadone maintenance. William White has provided a sweeping and engaging history of one of America's most enduring problems and the profession that was birthed to respond to it"--Back cover

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